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12574 Flagler Center Blvd Ste 101 Jacksonville FL 32258-2615 | |
| (315) 269-0847 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Mental Health (including Community Mental Health Center) |
| Location | 12574 Flagler Center Blvd Ste 101, Jacksonville, Florida |
| Authorized Official Name and Position | Victoria Kozel (CEO) |
| Authorized Official Contact | 9046795439 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
12574 Flagler Center Blvd Ste 101 Jacksonville FL 32258-2615 Ph: (315) 269-0847 | 12574 Flagler Center Blvd Ste 101 Jacksonville FL 32258-2615 Ph: (315) 269-0847 |
| NPI Number | 1811738768 |
|---|---|
| Provider Enumeration Date | 06/04/2024 |
| Last Update Date | 09/10/2024 |
| Certification Date | 09/10/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811738768 | NPI | - | NPPES |
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